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Sent By: HP LaserJet 3100; 4258249516; Idar-9-�F 1:27Ph�; Page 2/2 <br /> �'�::�RivliT APPLICATfON <br /> � CITY �p� EVtRETT PERIIAIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> U3U9U6 <br /> SITE ADDRESS PqFtC6L TA): I.D,# PERMIT# <br /> Ra181UDR5L•, CVL•RL'f7', V�'A 982U8 Q073�000001700 /'.���)�7 /O'�� // �i <br /> ��� <br /> IEGAL LOT NO. BL.00K ITRACT ! I <br /> OWNER AODRE33 PHONE <br /> UA\VSON,SUF 8'>18 IO DA:iE (425)147-20.54 <br /> • LVL•'ILL•'1'I�, R'A YN2U8 <br /> TENANT N�1ME CONTACT NAME PHONE <br /> PAMELAHILL 42i R14-3124x133 <br /> CONTRACTOR AppRESS CONTR.LICENSE# <br /> PAST WATFR �F.A'I'GR COMPANY I2601 132NU AVL NC FASTW WH946BC <br /> (425)R14•3124 KiRI:LAhD, WA 98J3a Ul/U3/ZUUtl <br /> PROPO5ED U5E OF BUILDING �+���no Mecnan�0e Wa�K namuon NEAT SOURCE <br /> PERh11T Combinaflun Pium�ln Allemtian I¢tdc <br /> TYPE Mmoli�kn b�yn NP� Naw ac <br /> ft� �IfRA�lnt he� <br /> CONTRACT PRICE OF WORK 5449.00 CI7Y OF EVERETT LOCqL SAI.�S TAX CODEIS 7to5 <br /> N�ORK DESCRIPTION Hemove/Replacc Gae Wnter Hea�er <br /> UMBI MECHANICAL <br /> KO. TYP OF UR R ITE t __T_,yj,€' _OF�IXTURE�R ITEM <br /> WATER CLOSET ______ fJC-AlHANOLING UNITS <br /> __ BAYHTUB ____ FORCED AIR SYSTEMS <br /> ____ LAVATORY(WASH BASIN) _____ HEaT PUMP <br /> �HOWER ____ �JNIT ►�EATERS <br /> KITCHEN SINK 3 DISPOSAL �_�_ CLOTNES DCtYER <br /> -' DISNWASHER _ RANGEHOOD <br /> LAUNOR'I TRAY � WATER HEATER <br /> � CLOTHES WASHER _.._ METAL FIREPIACEISTOVE <br /> URINAL _�__ FIREPLACE INSERT <br /> DRINKING FOUNTAIN .�_ QAS FIREPLACE <br /> FLOOR DlZ41N _ GAS RANOE <br /> BACKFLD1h' PREVENTER _�_ 6AS PIPING <br /> � SINK (3ERV�CEJBAWMOPlETG,) ___.__ F�(HAUST FAN <br /> -- o7HE�_ --- OTHER------__T-------- <br /> _�� ��,.,�_,��—._ --_ `��"'_'� -�— – <br /> I NEREav CERTIFY THAT I HAVE READ ANC EXAMINED THISAPLICATION AnD KNOW THE SANE TO BE TRUE ANO CORRECT.ALL <br /> PROviSI0N5 OF inWS nND ORoir�ANCES GOVERNINf;THIS TYPE OF WORK WILL 8E COMPLIED WIHT WHETHER SPECIFIED HEREi <br /> OR NOT.THE GRAkTING OF A PERMIT DOES NOT PRESUME TO flIVE AUTHORIlY TO VIOLATE OR f:ANCEL THE PROVISION OF ANY <br /> OTHER s7nTE OR LOCnI L4W REGULAT�NG CONSTRUCTION OR THE PERFORMANGE OF CONSiRUCTIOk.THAT l AfA AUTHOR¢ED <br /> BY THE OWNER OF THIS PROPERTY TO PERFOfiM THE•WORK FOR NM1CH APPIiCATION IS MAOE ANO�CON,PLY WITH THE STATE <br /> CONTRACTORS LAW 1927 RCW AND 2382001NAC. <br /> S(�neture o(0+�'nodContnctorlAuthnrited Agenl �,�:: �.,,- ,.4;.'�._�� A°�o 03�U)l200f: <br /> ui ni <br />